MYCO-VIRO Flashcards
Most common cause of outbreaks of tinea capitis in children.
Main cause of endothrix
Trichophyton tonsurans
Young child showing large circular erythematous scaly lesion with raised border on the nose
Microsporum gypseum
Causative agent of Tinea Versicolor
Malassezia Furfur
Spaghetti and meatballs apperance.
Hypopigmented spots on the ches and neck.
Causative agent?
Malassezia Furfur
Causes black nodules on the hair shaft, Affects mainly the scalp hair. Causative agent?
Piedraia Hortae.
Black Piedra
Forms Light coloured nodules on the hair of the beard, mustache and pubic hair. Afects the beard and Mustache hair.
Causative Agent?
Trichosporon Beigelii.
White Piedra
Typical brown to black non-scaling macules on the palmar aspect of the hands. Causative agent?
Tinea Nigra
Pigeon Droppings, Eucalyptus strees.
Seen as encapsulated yeast cells on India Ink.
Opportunistic fungi
Cryptococcus Neoformans
Causes Sporothricosis/ rose gardener’s disease.
Seen as Cigar-shaped budding yeast on specimens
Flowerette arrangement of conidia
Spororthrix schenckii
Barrel-shaped arthroconidia
Coccidioides Immitis
Mariner Pilot’s wheel
Coccidioides Brasilienses
Broad-Based Budding yeast
Blastomyces Dermatitidis
Dichotomously branching hyphae
Aspergillus Fumigatus
Associated with bird/ bat droppings
“Spelunker’s Disease”
resembles pulmonary TB in xray
Histoplasma Capsulatum
Fungi used in making wine, bread and beer
saccharomyces cerevisiae
Filoviruses causing hemorrhagic fevers
Marburg virus, Ebola virus
Filivirus exported from the philippines causing fatal infections in monkeys
Reston Virus
Paralytic Poliomyelitis and aseptic meningitis
fecal-oral route
Poliovirus
Herpangina, Hand-foot-and mouth disease
Coxsackie A virus
Pleurodynia (Bornholm Disease)
Myocarditis, Pericarditis
Coxsackie B
Major cause of acute diarrhea, infantile gastroenteritis
Rotavirus
Group of rotavirus known to cause disease in humans
rotavirus A, B, and C
Sixth Disease, exanthem subitum, caused by human herpesvirus type 6
Roseola
Clinical manifestations: erythema infectiosum, transient aplastic crisis, pure red cell aplasia, hydrops fetalis
Parvoviridae
Largest and most complex of viruses, manifests as rash
Poxviruses
More virulent poxvirus infections in human
Variola
Less virulent poxvirus infections in human
Vaccinia
He introduced vaccination with live cowpox virus in 1798
Edward Jenner
Control of smallpox by deliberated infection with mild forms of the disease
Variolation
The earliest physical evidnce of smallpox with pustular rash on the mummified body of?
Pharoah Ramses v
eosinophilic nuclear inclusions composed of nucleic acid and protein seen in cells infected with Herpes simplex virus, Varicella-zoster virus, and CMV
Cowdry A inclusions
inclusion bodies associated with polio, adenovirus
Cowdry B inclusions
inclusion bodies associated with Variola (small pox)
Guarnieri Bodies
inclusion bodies associated with Rubeola(measles)
Warthin finkeldey bodies
inclusion bodies associated with Rabies
Negri bodies
inclusion bodies associated with Molluscum contagiosum
Hendersen-petersen bodies
inclusion bodies associated with CMV
owl’s eye bodies
Enumerated the Herpes viruses “CHEV”
CMV, HSV,EBV, VZV
A smear of an opened skin vesicle to detect multinucleated giant cells.
Used to assay for HSV-1, HSV-2, and VZV
Tzanck Test
VZV route of transmission
respiratory droplet
reactivation of latent varicella zoster virus in sensory ganglia
Shingles
Herpes zoster
Appearance of shingle lesion
dewdrops on a rose petal
Most common intrauterine viral infection
cytomegalovirus
the tubular cells of the human kidney shed the virus for prolonged periods
Epstein-Barr virus
Causes infectious mononucleosis
Epstein-Barr virus
EBV heterophil antibodies detected by agglutination of sheep RBCs
monospot test
2 major influenza virus antigens
hemaglutinin(H) and Nueraminidase (N)
Avian flu: influenza A virus subtype
H5N1
Swine flu: influenza A virus subtype
H1N1
3 C’s of measles
couch, coryza, conjunctivitis
clustered, white lesions on the buccal mucosa (opposite the upper 1st & 2nd molars) and are pathognomonic for measles
Koplik spots
2 complications of measles virus
SSPE and giant cell pneumonia
Results from a persistent infection with altered measles virus harbored intracellularly in the CNS for many years usually (7-10) years
Subacute Sclerosing Panencephalitis (SSPE)
Hallmark of SSPE, resulting from extension of the inflammatory process site to deeper structures in the brain including the basal ganglia
Massive myoclonus
inclusion bodies of SSPE?
Cowdry A bodies
Pathognomonic microscopic finding for measles. Resulting from fusion of infected cells with up to 100 nuclei
Warthin-Finkeldy Giant Cells
Vitamin A recommended dosage for:
children >1 year?
6months to 1 year?
< 6months?
Capsule: single dose of 200,000 IU for children >1 year, 100, 000 IU for 6 months to 1 year, 50,000 iU for infants < 6months
cause of common cold, RNA virus
Rhinovirus
Viral disease of the CNS transmitted by infected secretions, usually saliva.
Bullet shaped.
Rabies virus
2 epidemiologic forms of rabies
- urban rabies (dogs and cats)
2. sylvatic rabies (bats, skunks, foxes, raccoons mongooses, wolves
inclusion bodies seen on rabies?
negri bodies
4 stages of rabies infection
- non-specific syndrome
- acute encephalitis
- brainstem dysfunction
- death or recovery
Hepatitis infection that is usually asymptomatic
Hep A
Hepatitis infection that is bloodborne
Hep B
Hepatitis infection that is associated with carcinoma, cirrhosis, and carrier state
Hep C
Hepatitis infection that is dependednt on HBV
Hep D
Hepatitis infection that is usually enteric, and seen on expectant mothers
Hep E
Hepatitis infection that is transmitted by fecal-oral route
Hep A and E
Synthesis of dsDNA form RNA
reverse transcriptase
HIV screening test
ELISA
HIV Confirmatory test
western blot
HIV indicator of active viral replication
P24 antigen
HIV marker of disease progression
HIV viral load
HIV monitoring of immune status
CD4 T-cell count
HIV detection of actively dividing virus
HIV viral load
HIV useful in determining when to initiate prophylaxis and treatment
CD4 T-cell count
most sensitive test for dx of acute HIV before seroconversion
HIV viral load
Detects anti gp-120 antibodies on HIV
ELISA
Presents before anti gp-120 antibodies on HIV
p24 antigen
bacterial opportunistic infections in AIDS
TB, M. avium
viral opportunistic infections in AIDS
HSV, VZV, CMV, PML(JC virus)
fungal opportunistic infections in AIDS
candida albicans, cryptococcal meningititis, Histoplasmosis, Pneumocytstis pneumonia
protozoan opportunistic infections in AIDS
toxoplasmosis, cryptosporidiosis
classification of staph and strep
3 Cs: catalase, coagulase, gram positive cocci
Group A streptococci, b Hemolytic
S. pyogenes
Group B streptococci, b hemolytic
common in babies
vaginal normal flora
S. agalactiae
Alpha hemolytic, gram (+) cocci
S. pneumonia
Encapsulated organisms:
(Strep Klb HaPN Cry)
- S. pneumonia
- K. pneumoniae
- H. influenzae
- P. aeruginosa
- N. meningitidis
- C. neoformans
primarily responsible for the beta hemolysis seen on the surface of a blood agar plate
Streptolysin S
S. pyogenes diagnosis by?
recent throat infection, recent skin infection
ASO- recent thorat infection
DNAse- recent skin infection
scarlet fever diagnostic test
Dick’s test
Fiery-red rash
erysipelas
s. pyogenes: abrupt onset of sore throat, fever and tender anterior cervical lymph nodes
pharyngitis
s. pyogenes: blanching sandpaper rah, circumoral pallor, strawbery tongue
scarlet fever
s. pyogenes: honey crusted lesions
impetigo
streptococcoal cause of dental caries
Streptococcus Mutans
Strep mutans produces a dextransducrase that forms an insoluble polymer of glucose known as?
Glucan
Golden yellow colonies?
this phenomenon is due to presence of what substance?
staphylococcus aureus,
staphyloxanthin
staph aureaus component that inhibits complement fixation and phagocytosis
Protein A
staph aureus component, superantigens that cause polyclonal t-cell activation
TSST-1( Toxic shock syndrome toxin)
staph aureus toxin causing staphylococcal scalded skin syndrome
exfoliatin
staph aureus toxin causing food poisoning
enterotoxins
pneumatocoeles of s. aureus is due to what substance?
Panton Valentin leukocidin
most severe form of SSSS
Ritter’s Disease
cause of osteomyelitis in general population
S. aureus
cause of osteomyelitis in sexually active
n. gonorheae
cause of osteomyelitis in drug users
p. aeruginosa
cause of osteomyelitis in sickle cell anemia
salmonella sp.
endocarditis in IV drug abusers commonly involves the?
trucuspid valve
Major cause of subacute endocarditis?
s. viridans
Major cause of acute endocarditis?
s, aureus
Major cause of endocarditis in drug abusers?
s. aureus
Major cause of endocarditis in prosthetic valves?
s. epidermidis
Bordetella pertussis culture medium
Bordet-Gengou medium, Regan-Lowe Medium
acute tracheobronchitis
whooping cough
stages of whooping cough
Catarrhal(1-2 weeks)
Paroxysmal(2-4 weeks)
Convalescence(>4wks)
chineses character appearance on microscopy
corynebacterium diphteriae
granules produced by corynebacterium?
volutin granules,
intracellular granules present in many species of bacteria, which possess a strong affinity for nuclear stains
babes ernst
granular cell inclusion that stains a color different from that of the dye used
metachromatic
medium/ agar used to culture corynebacterium
Loeffler’s coagulated medium
presents with sorethorat with pseudomembrane, bullneck, myocarditis, recurrent laryngeal nerve palsy, and muscle paralysis
Diphtheria
2 organisms which inactivates Elongation factor (EF-2) by ADP ribosylation
C. diptheriae
P, aeruginosa
Round terminal spores which gives cells a “drumstick” or “tennis racket” appearance
Clostridium tetani
Clostridium tetani blocks the release of these 2 inhibitory neurotransmitters
glycine
gamma-amino butyric acid
spinal inhibitory motor neuron cell
renshaw cell
innervation most sensitive to the c. tetani toxin
Masseter
first manifestation of c. tetani infection
trismus
manifestation of c. tetani in neonates
poor suck
ooisoning with this substance also produces Risus Sardonicus
strychnine poisoning
a grinning expression produced by spasm of the facial muscles; seen in tetanus and certain types of poisoning
Risus Sardonicus
DOC for tetanus
Metronidazole
phospholipase produced by Clostridium perfringens
Lecithinase
toxin produced by the bacterium Clostridium perfringens and is responsible for gas gangrene and myonecrosis
alpha toxin
Presents with skin crepitations with gangrenous wound
clostrium perfringens
management of c. perfringens
hyperbaric oxygen
blocks nueromuscular transmission by blocking the release of acetylcholine from motor nerve endings
Clostridium Botulinum
can contain spores of c. botulinum and should not be fed to babies less than 1 year of age
Honey
hospital or nursing home acquired clostridium infection
clostridium difficile
medications associated with clostridium difficile infection
clindamycin,
ampicillin,
cephalsporins
causative agent of pseudomembranous colitis (PMC)
clostridium difficile
most common manifestation of c. difficile infection
diarrhea
DOC for c. difficile infection
metronidazole (mild)
vancomycin (mod to severe)
responsible for virulence of MTB
cord factor-
trehalose dimycolate
causes serpentine growth in vitro
cord factor- trehalose dimycolate
DNA strip test that allows simultaneous molecular identification of TB and resistance to Rifampicin and INH
Line Probe Assay
responsible for caseous necrosis of MTB
Phosphatides
MTB in spine/bones on lower thoracic(chidren)/ upper lumbar vertebrae(adult)
Pott’s disease
provides a definitive diagnosis for active tuberculosis
used to monitor pts on treatment
confirms cure at end of tx
Direct sputum smear microscopy
“skip lesions”, cobblestone appearance on colon
TB of colon
Diease that develops in a previously uninfected person
primary tuberculosis
used ti screen asymptomatic, with TB exposure
PPD
standard test for diagnosing pulmonary tb in our country
sputum AFB
most common initial presentation of pulmonary TB
weight loss
most frequently involved extrapulmonary site of TB
lymph nodes
best initial test for TB
CXR
The most specific test for TB
sputum culture
Delayed hypersensitivity skin test to assay TB, cell mediated immunity to tubercle bacillus
Tuberculin skin test,
mantoux test
positive skin test for TB has induration greater than?
for immunocompromised patients?
> 10mm for immunocompetent,
>5mm for immunocompromised
natural resistance assoc macrophage protein(NRAM) Genetic protein for MAI
BEG GENE
3 main properties of anti TB drugs
bactericidal activity
sterilizing activity
prevents resistance
first line anti TB drugs
isoniazid(INH) Rifampicin ethambutol pyrazinamide(PZA) streptomycin
think (IRES)
second line anti TB drugs
(4Cplay Para Ka Of AmE) Cycloserine Capreomycin ciprofloxacin clofazimine para-amino salicylic acid kanamycin Ofloxacin amikacin ethionamide
it is recommended to prevent peripheral neuropathies of isoniazid
Pyridoxine(vit b6)
gold standard diagnosis of PTB
Acidfast smear and culture
treatment regimen of PTB
minimum of 6 months duration
INH EMB and RIF
side effect of isoniazid?
peripheral neuropathy
side effect of rifampicin
orange discoloration to body fluids
side effect of ethambutol
dose
retrobulbar neuritis, red green color blindness
>25mg/kg/d
side effect of pyrazinamide
hepatotoxicity
side effect of streptomycin
ototoxicity
other name of leprosy
Hansen’s disease
Only bacterium to invade peripheral nerves
mycobacterium leprae
where does M. leprae replicate primarily?
cool tissues of the skin and extremities
at what temperature does M. leprae proliferate best?
32°C to 34 °C
How is M. Leprae cultured?
in the footpads of mice and armadillos
M. leprae: cell-mediated immunity is manifested by delayed-type hypersensitivity reactions to dermal injections of a bacterial extract called
lepromin
response to these cells determines whether an individual has m. leprae is tuberculoid or lepromatous leprosy
helper t-lymphocytes
AFB: absent or few in number
positive lepromin skin test
CD4+helper t lympocyte predominate
tuberculoid leprosy (TT, BT)
Midpoint of the spectrum
most unstable form
“punched out” or “swiss cheese” appearance
borderline leprosy (BB)
AKA anergic leprosy,
AFB: numerous
negative lepromin test
cd8+t lymphocytes predominate
Polar lepromatous leprosy
facial presentation resulting from progressive bacillary proliferation, thickening of dermis, thrown into fods
Leonine facies
hairloss on eyebrows from leprosy
madarosis
mc nerve trunk involvement in type 1 lepra reactions
ulnar nerve
type 1 lepra reactions
- inflammation within skin lesions
- appearance of new skin lesions
- neuritis
- fever
type 2 lepra reactions
- crops of painful erythematous papules that resolve spontaneously
- malaise
- fever
aka diffuse lepromatosis
Latapi lepromatosis/ Lucio’s phenomenon
established treatment of leprosy
(CaRD)
Clofazimine
Rifampin
Dapsone
AIDS defining Mycobacterium infection
Mycobaccterium Avium Intracellulare(MAI)
Hallmark of MAI infections in patients with HIV
abundant acid-fast bacilli within macrophages
number one mycobacterium causing death in HIV
m. avium inrtracellulare
Causes fish tank granuloma
m. marinum
soitary cervical lymph nodes in kids
m. scrofulaceum
fast growing mycobacterium spp
m. fortuitum
acid fast, photochromogen(little or no pigment when grown in the dark but becomes highly pigmented when grown in light) mycobacterium spp
m. marinum
m. kansasii
cornerstone diagnosis of tuberculous meningitis
Lumbar puncture:
CSF leukocye: up to 1000/uL
CSF glucose <40mg/dL
CSF protein 1-8g/L
gold standard diagnosis of tuberculous meningitis
culture
Major cause of meningitis in newborn
s. agalactiae
Major cause of meningitis in children
h. influenzae
Major cause of meningitis in young adults
n. meningitidis
Major cause of meningitis in elderly
s. pneumonia
Major cause of meningitis in AIDS patients
c. neoformans
diseases caused by H. Influenzae
think (haEMOPhilus) Epiglottitis Meningitis Otitis media Pneumonia
Greenish metallic sheen on culture media
H. Influenzae
2 growth factors required by H. Influenze
X hematin
V- NAD
most important virulence factor of H. Influenzae
type B capsule
a phenomenon in which h. influenzae grows near s. aureus on blood agar
satellite phenomenon
K antigen
capsular antigen
O antigen
somatic AG
H antigen
Flagellar antigen
virulence factor in neonatal sepsis and meningitis
K1 capsule endotoxin
most common cause of UTI
e. coli
causative strain for traveler’s diarrhea
ETEC
2nd Most common cause of neonatal meningitis
E. COLI
aka Traveler’s diarrhea
Montezuma’s revenge
Hemolytic uremic syndrome causative agent
EHEC
Hemolytic uremic syndrome triad
think (ART/RAT)
anemia
thrombocytopenia
renal failure
Hemolytic uremic syndrome toxin
verotoxin (Shiga-LIKE)
Hemolytic uremic syndrome most common serotype
E. COLI 0157:H7
Hemolytic uremic syndrome associated food
undercooked beef (hamburger)
Hemolytic uremic syndrome associated plant
Spinach
Hemolytic uremic syndrome on spinach serotype
E. Coli EHEC 0104:H2
special serotype of E. Coli associated with outbreaks of infantile diarrhea among nursery patients
enteropathogenic E. Coli (EPEC)
Causative agent of honeymoon cystitis
E. COLI
Motile rods, with peritrichous flagella
salmonella
s. typhi and s. paratryphi serotypes which use man as hosts
serotypes A B C
s. typhi reservoir
gallbladder
typhoid fever is seen on which samples on 1st 2nd and 3rd week
1st week:blood
2nd: urine
3rd: stools
think(BUS)
typhoid fever diagnostic tests
widal test
typhidot
typhoid fever physical findings
fever, ab pain rash(rose spots) hepatosplenomegally epistaxis relative bradycardia at peak of high fever
typhoid fever tx
choramphenicol
chloromycetin
typhoid meningitis tx
ceftriaxone 2grams iv q 12 hours
gram(-) curved bacilli, oxidase(+), single polar flagella
vibrio
culture media for vibrios
TCBS- Thiosulfate citrate bile salt sucrose agar
rice watery stool
vibrio cholerae
v. cholera toxin causing pandemic
v. cholera 01- el tor
vibrio, hemolysin, gastroenteritis, seafoods
v. parahemolyticus
strain causing vibrio cellulitis
vibrio vulnificus
proteus antigens that cross-react withvarious strains of rickettsiae
OX-19, OX-2, OX-K
Proteus spp type of motility
swarming motility
Proteus spp type of flagella
peritrichous
Proteus spp pathogenic factor
urease production
Proteus spp type of renal stone
stag horn renal stone
magnesium-ammonium phosphate
pseudomonas pigments:
pyocyanin(blue-green)
fluorescein(green-yellow, fluorescent)
pseudomonas culture media
King’s A and B media
characteristic smell of pseudomonas culture
grape like
yellow-gren pigment that fluoresces under UV light, detects early infection in burn patient
pyoverdin
colors the pus in wound blue, damages cilia and mucosal clls of the respiratory tract
pyocyanin
pseudomonas type of skin lesion characterized by vesicles or blisters which rapidly evolve into pustules and necrotic ulcers with undermined tender erythematous border.
icthyma gangrenosum
causative agent: hot tub folliculitis, burn patients, icthyma gangrenosum
Pseudomonas Aeruginosa
most common causative agent for Otitis externa
Pseudomonas Aeruginosa
most common cause of pneumonia in ICU patients, ventilator associated, and cystic fibrosis
Pseudomonas Aeruginosa
Pseudomonas Aeruginosa DOC
Ceftazidime
Pseudomonas Aeruginosa coverage PO antibiotic
ciprofloxacin
Greenish metalic sheen
E. Coli
